Diabetes and Alcohol

Diabetes and alcohol
Diabetes and alcohol

There is no need for people with diabetes to give up alcohol simply because of their diabetes.

Although alcohol does have an effect on blood sugar levels, with a few precautions and careful management, people with diabetes can also enjoy a drink.

There are also alcohol substitutes for those who abstain.

In fact, diabetes alcohol guidelines are the same as for the general population.

What are the recommended alcohol guidelines for people with diabetes?

The guidelines are two units for women and three units for men. However, it is worth being aware how many units a drink contains.

In some cases, a glass of wine will constitute two units, and a pint of beer can even reach three units.


People with diabetes can drink alcohol and whether you decide to drink or how much you drink will be your personal choice. Different types of alcohol will affect blood sugar levels in different ways and this will largely be based on the carbohydrate content of each type.

Beer has a tendency to push sugar levels up, particularly if you have more than a single pint.

Wines tend to have less carbohydrate than beer so may have a less pronounced affect on sugar levels.

Spirits on their own, such as whiskey, vodka, rum and gin, have no significant carbs in and therefore shouldn’t push blood sugar values up. If you have them with a mixer this will need to be taken into account.

An important point to mention about alcohol and sugar levels is the sugar level crash that can happen - particularly over night. A short term affect of alcohol is that it can stop it from raising blood sugar.

A lot of people with diabetes find that after drinking this can cause sugar levels to drop. People who take diabetic medication, particularly insulin, need to be aware of this and may need to adjust doses to prevent hypoglycemia.

Ask your health team if you need help or advice with avoiding low blood sugar levels after alcohol.

Alcohol has a significant number of calories and so if you’re watching your weight, you may want to limit your alcohol intake. Alcohol can cause damage to organs such as the liver, heart and pancreas and even the skin.

People with diabetes are more susceptible to organ damage and so you may choose to reduce your alcohol intake for this reason.

How much alcohol do drinks usually contain?

If you have diabetes and are wondering how much alcohol you should drink, it is worth reading the following list to see how much alcohol is contained in each type of drink.

One unit (approximate measure):

  • 1/2 pint of standard strength beer, lager or cider
  • 1 pub shot/optic/measure (50ml) of sherry or vermouth
  • 1 pub shot/optic/measure of spirit (25 ml), eg gin, vodka or whisky.

So if I have diabetes I can drink as usual?

Not quite. People with diabetes need to be extra careful with alcohol.

Alcohol intake significantly increases the risk of hypoglycemia (low blood sugar levels). If your diabetes is already well under control, a moderate amount of alcohol may be fine either before, during or soon after a meal.

Even if you have a drink, this may not influence short-term blood glucose levels. However, there are some precautions to be taken care of.

What do I need to be careful of when it comes to diabetes and alcohol?

Avoid drinking on an empty stomach, as this will quickly increase the amount of alcohol in your bloodstream. Also avoid binge-drinking or sustained drinking, and never substitute alcohol for your meals. All of this can increase the risk of hypoglycaemia.

How will alcohol affect my blood sugar control?

Different alcoholic drinks will have varying effects on your blood sugar. It also depends how much you drink. A single alcoholic drink (a 330ml bottle of beer, medium glass of wine) may not have a huge effect on your overall blood sugar.

If you have more than a single drink, most alcoholic drinks will tend to initially raise your blood sugar.

Typically beers, lagers, wines, sherries and liqueurs will have this effect. However, alcohol inhibits the liver from turning proteins into glucose which means you're at a greater risk of hypoglycemia once your blood sugars start to come down. If you have a number of these drinks, you can expect to see a rise in blood sugar followed by a steady drop a number of hours later, often whilst asleep. People who take insulin, in particular, therefore need to be wary of hypoglycemia.

Each person will have a slightly different reaction to alcoholic drinks so it’s well worth using blood tests to check how your body responds to it.

Is drinking alcohol with diabetes dangerous?

Drinking lots of alcohol is dangerous for anyone. However, with larger amounts of alcohol, serious hypoglycaemia can occur.

Some sources (including Diabetes UK) advise strict carbohydrate management, perhaps even chips or pizza, if a large amount of alcohol has been consumed.

However, avoiding alcohol in large quantities is the best recourse.

Will I have a hypo whilst drunk?

The symptoms of drunkenness can be very similar to a hypo, which can lead to very dangerous confusion.

Furthermore, if you have been drinking heavily, there may be a risk of hypos for up to 16 hours (or even more) after you have stopped drinking.

Monitoring blood glucose levels closely is an essential part of managing your diabetes in this situation.

What other dangers does alcohol pose for people with diabetes?

Drinking alcohol in high quantities regularly can cause an increase in blood pressure. Furthermore, alcoholic drinks contain calories, and therefore can lead to weight gain. Drinking alcohol can exacerbate neuropathy by increasing pain and numbness.

Low carbohydrate and low-alcohol drinks may be better than standard alcohol, but the dangers still need to be considered.  Often alcohol is mixed with fizzy, sugary drinks that can impact on blood sugars.

So should I drink or not?

Drinking moderately in accord with the recommended guidelines, should definitely not be ruled out. Some alcohol, red wine in particular, may even offer health benefits… not that that means you should take up drinking.

Cost of drinking

Calculate the cost of drinking below or visit our Cost of Drinking Calculator for more information.

Your Comments
Alcohol and diabetes don't go well together full stop. I have been a weekend drinker with my wife who has been a diabetic for years. Neither of us are alcoholics but have both given the booze up as it will catch up with you if you are diabetic. It is also not much fun being the "sensible" head trying to look after the drunk diabetic who doesn't want to eat their chips etc. Too many close calls even on small amounts of alcohol to list. Generally peoples sugar levels are also really high when drinking that they think it is ok but it is miles more harmful long term. Yep don't let diabetes control you but don't let alcohol control you as it can also ruin your health and basic quality of life. Lecture over :)
Posted by Jason, Essex on Sunday, January 06, 2013
Hi, I suffer from reactive hypoglycaemia, after being misdiagnosed for 20 years, I have finally been diagnosed. However, I am not receiving any help from anyone. I quit sugar for 6 months but my symptoms seemed to get worse, brain fog, paranoia, mood swings, disorientation. The only time I actually feel well is when I don't eat! I have tried soya protein, isolate milk shakes and I seem to be ok with those. Has anyone else experienced my symptoms? Is there anything that can make these symptoms disappear?
Posted by Sophie , California on Tuesday, June 05, 2012
Hi, I'm a diabetic type 2 and a newbie to the site (Dr Briffa. com tipped me off to it). What you really want to worry about is DPN (diabetic peripheral neuropathy). It hurts, trust me - and both diabetes and excessive alcohol can bring it on. You may not decide to do it now, but it's pretty smart to cut down on alcohol in general and beer in particular. While you're about it check out Dr Briffa on bread. Now that's really dangerous stuff. :--)
Posted by Flod, Geneva, Switzerland. on Sunday, May 27, 2012
I like to go and have a beer, only about 3 pints, Friday and Saturday nights. I've got to find another drink low in calories. Can anyone help?
Posted by Alan Burton, Nether Broughton Leicestershier on Sunday, April 29, 2012
I'm out most weekends heavy drinking. Around 10 drinks or more a night. If it's beer, I will inject 2 units after 2 beers and if it's spirits with diet coke I will test after 2 drinks to monitor it was definitely diet and the need of sugar. Diabetes shouldn't control your life, you should control it! Most things nowadays are dangerous even for healthy people. You make the choice on what's worth it or not!
Posted by adam walsh on Friday, April 20, 2012
I am on Metformin and have found that I can have alcohol but I feel the effects ten times more. I always make sure I eat something, normally food that is slow releasing but the hard part is staying away from Burger King and their pesky onion rings! This may also be due to the severe weight loss I have gone through since September last year. The one good thing is that I seem to have more cash than normal!
Posted by fuzzelogik, London on Tuesday, March 20, 2012
I have found that since being on Metformin, alcohol give me really bad nausea so I find it easier not to drink. It doesn't mean I can't go out and enjoy myself. I've never liked the way some people assume that if I don't get totally rat a***d I can't be having fun. My only gripe is that as I'm not drinking it's normally assumed that I will be the designated driver!
Posted by Christine Lowe, Hants on Tuesday, February 07, 2012
Yes, it is true that there are no carbs in spirits ie: vodka, whiskey, Bacardi etc, so drinking neat or with DIET sodas are ok in moderation and require NO shots of rapid acting insulin. Sweet wines, beers, alco-pops, liquors contain sugar/carbs, many contain LOTS of sugar/carbs, especially alco-pops and liquors like Baileys, Disaranno, Scnapps.. DAFNE guidance: 1-2 small drinks containing carbs/sugar=no insulin necessary, any more than that requires 1/2 unit insulin per unit alcohol (1/2 lager, SMALL sweet wine, shot liquor). ALWAYS keep eye on BGs, ALWAYS eat 20g+ carbs AFTER drinking, especially before bed. I always been fine with these rules :) NEVER drink on empty stomach.. NO need for extra insulin in meals cooked with alcohol as it burns off.
Posted by JemmaDawn, England on Tuesday, December 13, 2011
My DSN told me I was very limited on what I could drink safely - lager, wine, beer. No cider, alcopops and certainly no shots. Brilliant news for a 19 year old!
Posted by Ali, Chester on Tuesday, December 06, 2011
We went out recently and I only had half a pint - and my blood sugar rocketed through the roof!
Posted by Arthur R, Chester on Thursday, August 04, 2011
The advice given is contrary for that given for users of Metformin. The leaflet says, 'no alcohol'!
Posted by Malcolm Bigg on Thursday, December 23, 2010
I found all the comments on alcohol very interesting being a newly diagnosed diabetic type 2 and feeling unsure as to what I can eat or drink. It was 4 weeks before I could get to see my diabetic nurse and people were telling me that I shouldn't eat this and that and in the end I was totally confused. I understand things a bit more now and do enjoy a drink at the weekend whilst enjoying a good film and occasionally one or two in the evenings. It seems to boil down to being moderate in all things.
Posted by Sue Morton, Northampton on Thursday, April 22, 2010
In accordance with my diabetic book The Diabetic Life by R.D.Lawrence I have been drinking Whisky with water for at least 20 odd years and I have been insulin dependant for 53 years. I have a couple of doubles every night and of cource eat well afterwards, but the book says there is no sugar in spririts. Is this true?
Posted by Stanley J Reed, Fife, Scotland on Tuesday, March 02, 2010
I drink beer which obviously contains alcohol, but it's also a carbohydrate. I find it makes my blood sugar level zoom up, but then by early morning the alcohol seems to kick in making it potentially low. As other people have said it is important that you have a good meal before drinking. I can have 3-4 pints with no problems on a full meal.
Posted by peter webber, Glos on Wednesday, February 03, 2010
I'm 21, been type 1 diabetic since I was 3. I'm in my final year of uni and have drunk to excess many times, especially on nights out with my friends. I've always made sure that before I even go home, I get chips from the chippy to balance my blood sugars out, then drink 2 glasses of water when I get home. This gets two results: 1 - I don't go hypo and 2 - I don't have a hangover! Although drinking too much is bad for you, I believe completely that you should learn what your limit is. Diabetes doesn't limit you, go out and be as normal as everyone else, just make sure you keep an eye on how you feel.
Posted by Krystyna, Cardiff on Tuesday, February 02, 2010
If you are going to drink then white spirits instead of dark, slimline instead of full fat, Pilsner instead of Lager or at a push Bud or any light beer with less sugar again. Ultimately, cutting down is the way forward - even 1 drink a week.
Posted by Damian McSor;ley, London on Tuesday, February 02, 2010
It's really interesting reading everyone's comments with regard to alcohol, and it's even more interesting to see how each comments varies greatly to the next. As a Type 1 Diabetic I believe that the guidance to drinking alcohol shouldn't differ from a non diabetic - it is all about drinking in moderation and within your limits. I know myself from my pre-diagnosis days that drinking makes you feel sluggish, tired and makes you put weight on and the same consequences apply now....it's just about recognising and managing the highs (from sugary drinks and beer) and the potential lows at night and the following day and just being a bit sensible (well, I try). Being diabetic should never stop you doing anything...it's just about being organised!
Posted by Claire, Alnwick, Northumberland on Tuesday, February 02, 2010
For a few years now I have substituted my preferred beer with a non or low alcohol content beer, and have varied the flavours, trying Kalibar, Bavaria, Cobra, Beck's, Blue etc. On none of the containers though, do I find any reference to sugar content. Might make our nights out at the pub a pleasure!
Posted by Caro, Somerset on Monday, December 28, 2009
I recently drank with new friends from work and drank too much! I can't remember much about the evening after a certain point. I had run out the pills for my diabetes and thought never mind I will do that next week - what a fool I was. Was ill for over a week and totally paraniod about the night for weeks as had a total black out for over 24 hrs! Won't be doing that again in a hurry - did not totally binge but was not happy of how I felt about me. Be warned.
Posted by karen purnell, Bristol on Friday, December 18, 2009
OMG! I guess I'm a lucky one then? I've been drinking for nearly 3 weeks now and feel the safest I have since diagnosis! My blood sugar is running high - fair enough, but better than low costantly.
Posted by david, inverness on Monday, December 14, 2009
I have been reading about drinking and taking insulin and I am shocked at the way people are saying it is dangerous to do this. I have been injecting insulin since 9 years of age and am now 36. I go out drinking when I get the chance and never have problems with hypos. I have a good meal before going out and something to eat again when I come home. People may say you need to test blood levels while you are out but this is not practical. You need to test when you get home and never go to bed without eating or drinking something, being diabetic is serious but it has never stopped me living a normal life.
Posted by martin andrew holroyd, england on Saturday, December 12, 2009
What about so called friends who get a kick out of putting an extra drink in your drink! That happened to me recently and it's put me off being sociable. I was lucky as I just got a hangover and upset stomach. You just can't tell some people can you? My friends all knew I was diabetic and was taking tablets for other conditions.
Posted by karen biddiss, weymouth on Friday, December 11, 2009
I would like to point out that although what you say all seems to fall in line with the Govennment guidelines on drinking, in the 25 years of my personal experiance as a type 1 diabetic they do not really appear true. Alcohol may contribute to hypos, but in most alcoholic drinks, whether they be beer, shorts, wine or ciders - there is an awfully high amount of sugar. The hypos may come later but very high blood sugars occur within minutes of some drinks.
Posted by Nicholas Smith, Crewe, Cheshire. on Friday, December 11, 2009
If we all followed every rule and guideline we would all be locked up. We have to work out what we can and what we can't tolerate sometimes, and as long as we eat before and after drinking. I drink lager, but have been told by so called professionals that I would be better drinking spirits with a Diet Coke mixer - but to me this causes more hypos.
Posted by Tam, Notts on Thursday, December 10, 2009
I think that it is up to the individual how much alcohol they consume. As a type 1 diabetic I have found that it is best to limit alcohol intake. I used to drink beer most nights, but found that it completely screwed up my blood sugar, and also found that it took several days before I felt normal again (if you call diabetes normal). I now only drink an odd glass of wine with a meal and feel a lot better for it, I also lost lost weight nearly 2Kgs, and my blood sugars have improved, so the consultant is impressed.
Posted by Multitasker, Nottinghamshire on Thursday, December 10, 2009
I think that beer is definitely something we should stay away from as diabetics - although it's hard to stay away from the pale ale! I find Vodka and Diet Cokes don't let my blood sugar levels stray to much - so I stick to that. I've been drinking it since I was 27 and I'm now 35, and so far, so good (touch wood). My advice would be drink in moderation - like most people's would be!
Posted by Penny, Argyll on Thursday, December 10, 2009
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